Senate Balks at Obama Pick for Surgeon General

WASHINGTON — Facing a possible defeat in the Senate, the White House is considering delaying a vote on President Obama’s choice for surgeon general or withdrawing the nomination altogether, an acknowledgment of its fraying relationship with Senate Democrats.

The nominee, Dr. Vivek H. Murthy, an internist and political ally of the president’s, has come under criticism from the National Rifle Association, and opposition from the gun-rights group has grown so intense that it has placed Democrats from conservative states, several of whom are up for re-election this year, in a difficult spot.

Senate aides said Friday that as many as 10 Democrats are believed to be considering a vote against Dr. Murthy, who has voiced support for various gun control measures like an assault weapons ban, mandatory safety training and ammunition sales limits.

The troubled nomination is the latest setback for a president who has struggled to get his nominees past members of his own party, even after Democrats changed filibuster rules to prevent repeated Republican blockades of Mr. Obama’s choices for cabinet jobs. Dr. Murthy is one of four nominees who has run into trouble this month after some Democrats have balked.

A White House official said Friday that after the defeat last week of Debo P. Adegbile, the president’s nominee to lead the Justice Department’s civil rights division, it became clear that the administration needed to adjust its approach to Dr. Murthy’s nomination. Mr. Adegbile’s nomination was shadowed by his involvement in the legal defense of Mumia Abu-Jamal in the appeal of his death sentence for killing a Philadelphia police officer, and the White House overestimated Democratic support.

“We are recalibrating our strategy around his floor vote,” said one senior White House official, who added that a range of options was being discussed. They included working with Democratic leaders to gain more support, delaying a vote until after the midterm elections, or allowing Dr. Murthy to withdraw.

“We expect him to ultimately get confirmed,” the official added, declining to be named because no final strategy has been decided.

Even before the White House’s acknowledgment on Friday, it was becoming clear how much the nomination was in jeopardy.

The N.R.A. is a powerful political force in many of the states where Democrats face their greatest threats this year in efforts to keep control of the Senate — like Alaska, Arkansas and Louisiana. The group has embarked on an aggressive campaign to rally its millions of members against Dr. Murthy. The latest effort came on Friday evening when the N.R.A. sent a “grass-roots alert” to millions of email subscribers, imploring them to “contact your senators and ask them to oppose confirmation of President Obama’s radically antigun nominee.”

Three Democratic Senate aides with knowledge of where members stood on the nomination said Friday that enough Democrats could oppose Dr. Murthy that he would most likely fail to be confirmed if a vote were held soon.

Senator Mark Begich of Alaska, who is up for re-election, has said that he will probably vote no. Mr. Begich, who has received angry letters from Alaskans who say they are alarmed by what they believe are Dr. Murthy’s antigun views, wrote to his constituents recently: “I will very likely vote ‘no’ on his nomination if it comes to the floor. I share your concern about Dr. Murthy’s views in favor of gun control.”

Coming nearly a year after a gun-control bill drawn up after the massacre at Sandy Hook Elementary School in Connecticut went down in defeat in the Senate, the N.R.A.’s highly aggressive and visible campaign against Dr. Murthy shows how the organization has determined that its greatest chances for success in Congress come when it holds nothing back.

The group has already begun gearing up to be a strong presence in congressional and governor’s races. Since late last year, it has hired dozens of field strategists to begin laying the groundwork for campaigns in politically competitive states.

Though Dr. Murthy has expressed a desire to see more restrictions on how guns can be purchased and who can own them — views in step with where many Americans stand on gun control — the N.R.A. has dismissed him as a radical.

In a letter to senators last month, Chris W. Cox, the group’s chief political strategist, mentions Dr. Murthy’s support for limits on ammunition purchases, a ban on “popular semiautomatic firearms” and the removal of restrictions that keep the Centers for Disease Control and Prevention from funding “antigun advocacy research.” Mr. Cox also cited Dr. Murthy’s calls for a federal gun buyback program for assault weapons and for mandatory safety training for gun owners. Dr. Murthy has said his concerns about guns stem from his experience in the emergency room where he has witnessed the trauma that gun violence can cause.

The surgeon general’s office — which deals with policies of medicine and public health — is not usually a focus of gun-rights advocates. But an N.R.A. spokesman, Andrew Arulanandam, said that it was taking no chances that under Dr. Murthy the office would veer into gun policy. “All the rules have changed as far as this White House is concerned,” he said. “Given Dr. Murthy’s blatant activism on behalf of gun control, that’s not a gamble we’re willing to take.”

The N.R.A. has said it will “score” any confirmation vote — meaning that voting yes would negatively affect a senator’s annual rating from the group. This is not an idle concern for senators like Mr. Begich, Mary L. Landrieu of Louisiana, Mark Pryor of Arkansas and John Walsh of Montana — all Democrats who represent states where opposition from the N.R.A. could mean the difference in a close race.

The White House could probably only afford to lose no more than six Democrats in the vote on Dr. Murthy because Republicans are not likely to provide much support. Only one, Mark S. Kirk of Illinois, voted in the Health, Education, Labor and Pensions Committee to send the nomination to the full Senate. Senator Harry Reid, the majority leader, has not scheduled that vote.

A version of this article appears in print on , on Page A1 of the New York edition with the headline: Senate Balks at Obama Pick for Health Post. Order Reprints | Today’s Paper | Subscribe